To investigate the clinical efficacy of ginkgo biloba extract (GBE) on patients with diabetic kidney disease (DKD) and its influence on exosome microRNA-342-3p (miR-342-3p).

A total of 95 DKD patients who received outpatient treatment or inpatient treatment in the Department of Endocrinology of the First People's Hospital of Fuyang, Hangzhou from May 2022 to September 2022 were included and divided into a control group (n = 50) and an observation group (n = 45) by the random number table. The control group received standard treatment according to the "Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition)", and the observation group was treated with GBE on the basis of the control group. The levels of urinary albumin/creatinine ratio (UACR), serum creatinine (Scr), blood urea nitrogen (BUN), fasting blood glucose (FBG), glycated haemoglobin A_1c (HbA_1c), homeostasis model assessment-insulin resistance (HOMA-IR), low-density lipoprotein cholesterol (LDL-C), white blood cells (WBC), hemoglobin (Hb), platelets (PLT), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and urinary exosome miR-342-3p were compared between the two groups before and after treatment.

Before treatment, there were no significant differences in the levels of UACR, Scr, BUN, FBG, HbA_1c, HOMA-IR, LDL-C, WBC, Hb, PLT, ALT, AST and exosome miR-342-3p between the two groups (all P > 0.05). After six months of treatment, the levels of UACR (t = 4.012, 9.250; both P < 0.001), FBG (t = 14.618, 6.353; both P < 0.001), HbA_1c (t = 10.661, 5.715; both P < 0.001), HOMA-IR (t = 6.658, 3.225; both P < 0.001), LDL-C (t = 16.968, 19.197; both P < 0.001) and miR-342-3p (t = 63.635, 36.801; both P < 0.001) of the observation group and control group were significantly lower than those before treatment. Meanwhile, the levels of UACR (t = 3.299, P = 0.001), FBG (t = 3.114, P = 0.002), HbA_1c (t = 2.127, P = 0.036), HOMA-IR (t = 2.736, P = 0.007), LDL-C (t = 2.805, P = 0.006) and miR-342-3p (t = 4.379, P < 0.001) were lower in the observation group than in the control group after treatment. However, there were no significant differences in the levels of WBC, Hb, PLT, ALT and AST between the two groups before and after treatment (all P > 0.05).

With a certain renal protection effect, GBE can effectively reduce UACR, regulate blood sugar and lipid, and improve insulin resistance in DKD patients, which may be related to the down-regulation of the exosome miR-342-3p level.